Do Patient-Centered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of Low-Income Patients? A Systematic Review and Meta-Analysis

Carissa van den Berk-Clark, Emily Doucette, Fred Rottnek, William Manard, Mayra Aragon Prada, Rachel Hughes, Tyler Lawrence, F. David Schneider

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objectives: To examine: (1) what elements of patient-centered medical homes (PCMHs) are typically provided to low-income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low-income groups. Data Sources/Study Setting: Existing literature on PCMH utilization among health care organizations serving low-income populations. Study Design: Systematic review and meta-analysis. Data Collection/Extraction Methods: We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low-income populations. A total of 434 studies were reviewed. Thirty-three articles met eligibility criteria. Principal Findings: Patient-centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range −0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = −0.248), but there were apparent limitations in study quality. Conclusions: Evidence shows that the PCMH model can increase health outcomes among low-income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed.

Original languageEnglish (US)
Pages (from-to)1777-1798
Number of pages22
JournalHealth Services Research
Volume53
Issue number3
DOIs
StatePublished - Jun 2018

Keywords

  • Patient-centered medical home
  • implementation
  • poverty
  • underserved patients

ASJC Scopus subject areas

  • Health Policy

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